AF is back, taking Sotalol and Propafenon

Have been taking Sotalol 80Mg twice a day for app 15 years to keep my paroxysmal AF in check. A year ago my Mitral Valve was replaced with a tissue valve and I had the Maze and the LLA was closed as well. Was in AF for 2 month after op then 99% sinus until 2 weeks ago. Occasional sinus for a few minutes to at one time about 45 min while sleeping. Have my own Holter. Dr wants to add 225mg of Propafenon twice a day. Is that ok with the Sotalol and generally how effective is the Propafenon ?

We are not doctors here, and we cannot give medical advice, so weighing in on whether it's OK to have sotalol and propafenone together is outside of our expertise here. Hopefully, you're seeing an electrophysiologist as they are the most up-to-date on meds for afib.

But just in general, both are antiarrhythmic (rhythm control) drugs, and both also have beta-blocking (rate control) properties. Dr. Prystowsky, one of the world's afib experts (he wrote a drug textbook for doctors for treating arrhythmias), mentioned in the videos we are currently editing to post soon that sometimes lower doses of two rate control drugs can give you good rate control and fewer side effects, but I don't know if this also applies to rhythm control drugs. He also mentioned that propafenone should not be used in someone with asthma. And he did mention that 80 mg of sotalol twice a day is a lower dose.

Other than sharing these comments, we can't really help other than if someone has been on both drugs and can share their experience. Since it is less common to be on both, I don't know if this applies to anyone here.

Mellanie

Silverstar,
January 14, 2019 10:58am EST

Just wanted to know if anyone can recommend a cardiologists at Maimonides medical center in brooklyn

Gene157,
January 14, 2019 7:07pm EST

Thank You for the input Mellanie.

It is now day three on the Propafenone and there have been several more hours of sinus mode, so I hope that it will be more and more. Hope to get a electrical re-set, had several over the years and worked every time. However the attitude appears to be why bother, the AF will eventually be back.

In regard to re-modeling while in AF, how much time is there before it is too late?

Again, thanks for the reply

Eugene

Thumper2,
January 15, 2019 6:51am EST

Eugene, in response to your question about remodeling while in AFib, I can only recommend that you see your electrophysiologist (EP) about having one or more ablations,which MAY "fix" your AFib. I was in AFib for about 10 years before seeing an EP (rather than a cardiologist), and by then neither cardioversions nor ablations got me back to NSR. "The sooner the better" seems to be a good idea. Keep us posted as to your progress.

Thumper2 (Judy)

Gene157,
January 15, 2019 1:38pm EST

Thank you Judy

Sorry it did not work for you, big disappointment! My understanding is that even after a few month of AF the odds of success are going down.

I had one ablation app 16 month ago and that helped. But the scarring "MAY" have created mitral valve leakage. So now I have a tissue valve. And the gold standard for AF, the maze procedure, was done and appeared to help for a while. It appears my heart is determined to be in AF mode. Bummer.

Day four on Propafenone and more sinus time but at a high resting rate 85 to 110 bpm, my sinus resting rate is 65 bpm or less

Eugene

My spell checker is not working, how do I turn it on?

Gene157,
January 16, 2019 12:52pm EST

Day five,

Sinus mode is 100% back, resting rate at 65bpm down from 85 to over 100. Dr wants me to stay a little longer on this regimen, to see if S mode stays. Will then get off Coumadin too.

I have for years taken the following supplements, Magnesium, COQ10, Vitamin C, Taurine, Acetyl L Carnitine and firmly believe that they have been beneficial. Now 86 years old and in fairly good shape, park my car at the end of the parking lot etc.

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